Evaluating the Safety of Labour in Women With a Placental Edge 11 to 20 mm From the Internal Cervical Os
Open accessAbstract
Objective The purpose of this study was to evaluate pregnancy outcomes in a cohort of women with a placental edge between 11 and 20 mm from the internal cervical os, and to determine the likelihood of a successful vaginal delivery when trial of labour is attempted in these women.Methods We carried out a prospective observational study of women with singleton pregnancies and a placental edge between 11 and 20 mm from the internal cervical os (identified by transvaginal sonography) who underwent a trial of labour.Results Fourteen women with the above characteristics underwent a trial of labour during the study period. The mean interval (± SD) from ultrasound to delivery was 17.2 ± 9.6 days. Thirteen women (92.9%) delivered vaginally with no complications, and only one woman (7.1%) required an emergency Caesarean section for intrapartum bleeding. The risks of antepartum and postpartum hemorrhage were 21.4% and 14.3%, respectively.Conclusion Having a placental edge more than 10 mm from the internal os, measured by transvaginal sonography near term, justifies allowing a trial of labour and carries a low risk of subsequent obstetrical hemorrhage.
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The corresponding studies on ultrasound features and mode of delivery are small, observational and retrospective.
“The corresponding studies are small, observational and retrospective, making a recommendation for a specific mode of delivery based on ultrasound findings difficult.”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [81]
The Methods describe a prospective observational study, and the Results report only 14 women who underwent a trial of labour. The Discussion acknowledges the small sample and mentions a separate retrospective observational study. Thus the cited study supports 'small' and 'observational,' but it was not retrospective; it also proposes delivery recommendations based on ultrasound-measured placental distance. Page numbers were not available in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measuredSuccess rates of vaginal delivery when the placental edge is between 10 and 20 mm from the internal os vary widely (56% and 93%).
“the success rates of vaginal delivery when the placental edge is between 10 and 20 mm from the internal os vary widely (56% and 93%, respectively).[79][80][81][82]”
From Placenta Praevia and Placenta Accreta: Diagnosis and Management: Green‐top Guideline No. 27a (2019) · cites this paper as [81]
The Results report that 13 of 14 women (92.9%) with a placental edge 11–20 mm from the internal os delivered vaginally after a trial of labour, supporting the 93% figure. This paper does not report a 56% success rate; the other rate it discusses for this distance is 76.5% (Discussion). (LLM, conf=0.86)
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References 15 · Cited by 25
Research works printed but not linked: 1
- [13]13. Sallout B, Oppenheimer LW. The classification of placenta previa based on os-placental edge distance at transvaginal sonography. Am J Obstet Gynecol 2002;187(6): S94.
- Authors
- Al Wadi, K., Schneider, C., Burym, C., Reid, G., Hunt, J., & Menticoglou, S.
- Affiliations
- University of Manitoba (CA)
- Venue
- Journal of Obstetrics and Gynaecology Canada
- Publisher
- Elsevier BV
- Published
- 2014-08
- Volume
- 36
- Issue
- 8
- Pages
- 674-677
- ISSN
- 1701-2163 (ISSN-L)
- OpenAlex
- W2183845888
- Cited by
- 25
- References
- 15
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 2 · 2022: 3 · 2021: 2 · 2020: 3 · 2019: 1 · 2018: 4 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 2
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Obstetrics and Gynaecology Canada (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Manitoba
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Maternal and fetal healthcare
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › Pregnancy and preeclampsia studies
- Keywords
- trial of labor, vaginal delivery, obstetric hemorrhage, antepartum hemorrhage, postpartum hemorrhage, emergency cesarean section, transvaginal ultrasound, singleton pregnancy, labour safety
- MeSH terms
- Adult, Female, Postpartum Hemorrhage, Humans, Placenta, Pregnancy, Pregnancy Outcome, Prospective Studies, Ultrasonography, Delivery, Obstetric
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